Provider Demographics
NPI:1548766199
Name:FRIEDRICH, MICHAELA NICOLE
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:NICOLE
Last Name:FRIEDRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 AGATHA CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1712
Mailing Address - Country:US
Mailing Address - Phone:415-209-3307
Mailing Address - Fax:
Practice Address - Street 1:450 STANYAN ST # 3N
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1019
Practice Address - Country:US
Practice Address - Phone:415-750-5580
Practice Address - Fax:415-750-4919
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program